APS is sometimes called "sticky blood syndrome"colloquially because of the increased clotting tendency. It is more commonly seen in people assigned female at birth and is often diagnosed after multiple pregnancy losses or unexplained blood clots. The prevalence of antiphospholipid antibodies (aPL) among Indian individuals with recurrent pregnancy loss (RPL) varies across studies. While some research indicates a rate of around 15-20%, a study conducted in Calcutta reported a prevalence of 27.7%. This variation highlights the importance of considering aPL screening in RPL cases to enable early intervention.
How APS Affects Pregnancy
If you have APS, your pregnancy may be at a higher risk for complications such as:- Recurrent miscarriage, especially in the first trimester
- Stillbirth in the second or third trimester
- Pre-eclampsia or high blood pressure
- Intrauterine growth restriction (IUGR), where the baby grows more slowly than expected
- Preterm birth due to placental problems
Symptoms and Warning Signs
APS does not always show symptoms until complications occur. However, some signs to watch out for include:- Two or more consecutive clinical pregnancy losses before 20 weeks of gestation
- A history of blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism)
- Stroke or mini-stroke at a young age
- Unexplained headaches or migraines
- Skin rashes such as livedo reticularis (a mottled appearance)
- Low platelet counts
How APS Is Diagnosed
Diagnosis of APS is based on both clinical history and blood tests. Your doctor will:- Review your history of pregnancy losses, clotting episodes, or autoimmune conditions
- Test for anticardiolipin antibodies, lupus anticoagulant, and anti-beta-2 glycoprotein I antibodies
- Repeat these tests 12 weeks apart to confirm persistence of the antibodies
Can You Get Pregnant with APS?
Yes, you can conceive and carry a pregnancy with APS. But close monitoring and early intervention are important to reduce complications. Many people with APS have successful pregnancies after treatment is started.In fact, studies have shown that with proper management, usually a combination of low-dose aspirin and anticoagulants, up to 70–90% of individuals with APS can carry a pregnancy to term.
Treatment and Management Options
Treatment for APS during pregnancy focuses on improving blood flow to the placenta and preventing clots. Your doctor may recommend:- Low-dose aspirin to reduce blood clotting risk
- Heparin injections (a blood thinner considered safe in pregnancy)
- Regular ultrasounds to monitor the baby’s growth and placental function
- Frequent check-ups to detect complications like pre-eclampsia early
Postpartum Management in APS
The postpartum period is particularly critical for those with APS. Due to the heightened clotting risk in the six weeks following delivery, the following measures are typically advised:- Anticoagulation Therapy: Continuation of low-molecular-weight heparin (LMWH) is often recommended for at least six weeks postpartum. Depending on your individual risk, this may extend up to 12 weeks.
- Monitoring: Be alert for symptoms such as pain, swelling, or redness in the limbs, or sudden breathlessness, as these may indicate a clot.
- Multidisciplinary Care: Your care team may include obstetricians, haematologists, and primary care providers.
- Patient Education: Understanding the importance of postnatal medication and follow-up appointments is crucial to avoid serious complications.
Emotional and Practical Support
Receiving a diagnosis like APS can feel overwhelming. Many parents worry about what it means for their chances of a healthy pregnancy. If you're struggling:- Connect with a perinatal counsellor or therapist
- Join support groups where others share their experiences with APS and high-risk pregnancy
- Involve your partner or family in your care and follow-up
While Antiphospholipid Syndrome may sound daunting, it does not mean the end of your hopes for a healthy pregnancy. With early diagnosis, evidence-based treatment, and a committed care team, most individuals with APS can have safe and successful pregnancies. What matters most is staying informed, following your treatment plan closely, and being proactive about your health, both during and after pregnancy. If you’ve experienced repeated pregnancy loss or unexplained complications, it’s worth exploring whether APS could be a contributing factor. Support is available, and with the right guidance, you can navigate this condition with strength, clarity, and hope.
FAQs on Antiphospholipid Syndrome and Pregnancy
- Can APS cause infertility?
APS does not usually affect the ability to conceive, but may increase miscarriage risk if untreated. - Can APS go away after pregnancy?
No, APS is a lifelong autoimmune condition. However, its symptoms may vary over time. Continued follow-up is necessary. - Is APS the same as thrombophilia?
APS is one type of acquired thrombophilia. It specifically involves antibodies that increase clot risk. - What happens after delivery if you have APS?
You may need to continue anticoagulants for 6–12 weeks after birth to prevent clots. Your doctor will create a personalised plan. - Is APS genetic?
APS is not directly inherited, but some genetic tendencies to clotting may run in families. Having a close relative with an autoimmune disease may increase your risk.
